Health Care Insurance Business Process Application Error Codes

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This Insurance Business Process Application Error Codes list is for use by all users across the insurance and healthcare industry. It has information on business process application error codes and their descriptions, status of the codes whether active, to be deactivated or deactivated.

Complexity

This Insurance Business Process Application Error Codes list also referred to as ASC X12 External Code Source 895 is for use by insurance companies, members, payers, subscribers, patients, TPA, broker, billing provider, and all other stakeholders in the healthcare industry. It gives a summary of business process errors and their corresponding codes.
This code list may also be used for responses to inquiries regarding provider participation or registration in a program or plan.

The Centers for Medicare & Medicaid Services (CMS) maintain and annually update a List of Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) Codes (Code List), which identifies all the items and services included within certain DHS categories. CMS updates the Code List to conform the list to the most recent publications of CPT and HCPCS and to account for changes in Medicare coverage and payment policies. The updated Code List is published in the Federal Register as an addendum to the annual Physician Fee Schedule final rule. That rule is usually published in November and generally becomes effective January 1 of the following year. In addition, we may publish other rules or correction notices that may change the Code List. CMS posts any changes to the Code List on its webpage as soon as possible after publication in the Federal Register.

The DHS categories defined by the Code List are:
– Clinical laboratory services;
– Physical therapy services, occupational therapy services, outpatient speech-language pathology services;
– Radiology and certain other imaging services; and
– Radiation therapy services and supplies.

**NOTE**: The following DHS categories are defined at 42 CFR ยง411.351 without reference to the Code List:
– Durable medical equipment and supplies;
– Parenteral and enteral nutrients, equipment and supplies;
– Prosthetics, orthotics, and prosthetic devices and supplies;
– Home health services;
– Outpatient prescription drugs; and
– Inpatient and outpatient hospital services.

Date Created

2004-05-01

Last Modified

2018-03-01

Version

2018-03-01

Update Frequency

Irregular

Temporal Coverage

2004 to 2017

Spatial Coverage

United States

Source

John Snow Labs; Centers of Medicare and Medicaid Services (CMS);

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

Insurance Business Process Application Error Codes, Credentialing Transactions, Insurance Application Error Codes, Insurance Process Errors, Insurance Business Process Errors, Electronic Data Interchange (EDI) Transactions, Electronic Data Interchange (EDI) Code, Electronic Data Interchange (EDI) List, Medical Claims Processing, Insurance Claim Process

Other Titles

Health Insurance Portability and Accountability Act (HIPAA) Standard Electronic Transactions, Medicare Appropriate Insurance Business Process Application Error Codes, Health Care Application Error Inquiries, Electronic Data Interchange (EDI) Transactions for Insurance Business Process Application Error Codes, Electronic Data Interchange (EDI) Code for Insurance Business Process Application Error Codes, Electronic Data Interchange (EDI) List for Insurance Business Process Application Error Codes

NameDescriptionTypeConstraints
CodeInsurance Business Process Application Error Codesstringunique : 1 required : 1
DescriptionDescription for each Insurance Business Process Application Error Codestringrequired : 1
Start_DateDate the Insurance Business Process Application Error Code started usagedaterequired : 1
Last_ModifiedDate the Insurance Business Process Application Error Code was changed/modifieddate-
StatusCode update whether Active, To be Deactivated or Deactivatedstringrequired : 1
CodeDescriptionStart DateLast ModifiedStatus
E001Missing/Invalid submitter identifier2004-05-01Active
W001Missing/Invalid submitter identifier2004-05-01Active
E002Missing/Invalid receiver identifier2004-05-01Active
W002Missing/Invalid receiver identifier2004-05-01Active
E003Missing/Invalid member identifier2004-05-01Active
W003Missing/Invalid member identifier2004-05-01Active
E004Missing/Invalid subscriber identifier2004-05-01Active
W004Missing/Invalid subscriber identifier2004-05-01Active
E005Missing/Invalid patient identifier2004-05-01Active
W005Missing/Invalid patient identifier2004-05-01Active